The psychoactive effects of psychiatric medications have been obscured by the presumption that these medications have disease-specific actions. This research paper discusses how psychoactive effects produced by different drugs prescribed in psychiatric practice might modify various disturbing and distressing symptoms, and also considers the costs of these psychoactive effects on the mental well-being of the user. The authors examine the issue of dependence, and the need for support for people wishing to withdraw from psychiatric medication. They also consider how the reality of psychoactive effects undermines the idea that psychiatric drugs work by targeting underlying disease processes, since psychoactive effects can themselves directly modify mental and behavioral symptoms and thus affect the results of placebo-controlled trials. These effects and their impact also raise questions about the validity and importance of modern diagnosis systems.